SEIU United Healthcare Workers West
A California-wide healthcare workers' local union affiliated with the Service Employees International Union.
Last updated October 14, 2026
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Overview
SEIU United Healthcare Workers West, commonly known as SEIU-UHW, is a statewide local union of the Service Employees International Union in California. It represents workers across the healthcare sector, including employees of hospitals, nursing homes, clinics, home-health agencies, and homecare services. Unlike a consumer-facing commercial brand, SEIU-UHW is an institutional labor organization whose activities center on collective bargaining, workplace representation, organizing campaigns, political advocacy, and public policy initiatives affecting healthcare employment and delivery. The local is headquartered in Oakland and maintains offices and organizing activity throughout California. Its institutional base was formed through the 2004 merger of two historically important SEIU predecessors: Northern California Local 250 and Southern California Local 399. Local 250 traced its origins to hospital workers who organized at San Francisco General Hospital after the 1934 San Francisco general strike. It later affiliated with the Building Service Employees International Union, the predecessor organization that became SEIU. Local 399 emerged in Southern California in 1949 through the consolidation of smaller unions and soon negotiated an agreement with the first Kaiser Permanente hospital in Los Angeles. The two predecessor locals had already collaborated on major labor and legislative efforts. In 1958, they participated in the campaign against California Proposition 18, a right-to-work measure. After the Building Service Employees International Union adopted the SEIU name in 1968, the locals worked together in 1974 to support a change in federal law that made it easier for nonprofit hospitals to organize. Their eventual merger created SEIU-United Healthcare Workers West, also identified as SEIU Local 2005. The organization experienced a major internal conflict in 2009, when SEIU placed the local under trusteeship and removed approximately 70 executives, including then-president Sal Rosselli. Rosselli and other former leaders subsequently established the National Union of Healthcare Workers, producing a prolonged contest over representation at numerous healthcare facilities. In subsequent elections, more than 73,000 members voted to remain represented by SEIU-UHW, although the dispute significantly shaped the local's public identity and organizational history. SEIU-UHW's collective-bargaining record includes contracts and organizing campaigns involving Kaiser Permanente, Sutter Health, Catholic Healthcare West, HCA, retirement communities, hospitals, and healthcare information-technology workers. A 2010 Kaiser Permanente agreement covered approximately 46,000 California employees and included annual wage increases of 3 percent. The union has also supported strikes, including a six-week Sutter Health strike in San Francisco, and has organized workers at facilities such as St. Vincent Medical Center, Parkview Community Hospital, and O'Connor Woods Retirement Community. Some organizing victories were later reversed, including the decertification of O'Connor Woods' bargaining unit. Since 2012, SEIU-UHW has also become a prominent participant in California ballot politics. It has sponsored or supported numerous initiatives seeking greater regulation of healthcare companies. Its most visible campaigns concerned kidney dialysis clinics: Proposition 8 in 2018, Proposition 23 in 2020, and Proposition 29 in 2022. The measures addressed issues including clinic profits and the presence of physicians or other qualified medical professionals during dialysis treatment. Critics, including political groups, hospital organizations, other labor unions, and some Democratic figures, argued that the campaigns were intended to pressure dialysis providers into accepting unionization rather than solely to advance patient-safety policy. SEIU-UHW has disputed that characterization and presented the initiatives as healthcare-regulation and safety measures. During the COVID-19 pandemic, the union announced in March 2020 that it had located a potential stockpile of 39 million N95 masks for purchase by healthcare systems and government agencies. It later clarified that it had no financial interest in the proposed transactions. In April 2020, the union and other intermediaries learned that the purported stockpile did not exist and that they had been targeted by a scheme uncovered during federal efforts to obtain protective equipment. The episode became one of the most consequential controversies associated with the organization. In 2020, SEIU-UHW was reported to have approximately 97,000 members, down from nearly 150,000 in 2013. Its current identity combines traditional union representation with statewide organizing, healthcare-sector advocacy, electoral campaigning, and efforts to influence the regulation of major healthcare providers.
History
SEIU United Healthcare Workers West was created in 2004 through the merger of SEIU Local 250 in Northern California and SEIU Local 399 in Southern California. The two locals had separate institutional histories but shared a long record of cooperation in healthcare labor and public policy. Local 250 originated with workers at San Francisco General Hospital. Inspired in part by the 1934 San Francisco general strike, hospital employees organized in 1934 as Hospital and Institutional Workers Union No. 19818. The organization later affiliated with the Building Service Employees International Union and became Local 250. Its development reflected the expansion of organized labor among hospital and institutional workers in Northern California. Local 399 developed in Southern California in 1949, when several smaller unions were consolidated under Charles “Pop” Hardy, a BSEIU leader who sought to build bargaining strength by uniting fragmented local organizations. In 1950, Local 399 negotiated an agreement with the first Kaiser Permanente hospital in Los Angeles, establishing an early foothold in one of the region's most important healthcare systems. The predecessor locals worked together politically before their merger. In 1958, Local 250 and Local 399 participated in the BSEIU campaign against Proposition 18, a proposed right-to-work measure. Following the BSEIU's 1968 name change to the Service Employees International Union, the two locals again collaborated in 1974 to support federal legislation allowing nonprofit hospitals to organize more readily. Their merger in 2004 produced SEIU-United Healthcare Workers West, also known as SEIU Local 2005. The local's most disruptive episode occurred in January 2009. SEIU placed UHW West under trusteeship and removed around 70 local executives, including president Sal Rosselli. Rosselli and allied former officials organized the National Union of Healthcare Workers, which challenged SEIU's representation through decertification elections at dozens of healthcare facilities. The resulting conflict became a highly visible dispute over local autonomy, centralized union control, and the direction of healthcare-worker organizing. In elections held after the split, more than 73,000 members voted to remain with SEIU-UHW, although NUHW continued to compete for representation in parts of the sector. SEIU-UHW subsequently pursued bargaining, strikes, and organizing across California. It negotiated a statewide agreement with HCA, described as the largest hospital company in the United States, and reached agreements involving Catholic Healthcare West and Kaiser Permanente. In June 2010, Kaiser workers represented by the local ratified a contract covering approximately 46,000 California employees and providing annual wage increases of 3 percent. The union also supported a six-week strike involving Sutter Health workers in San Francisco. Organizing campaigns produced victories at St. Vincent Medical Center in Los Angeles, Parkview Community Hospital in Riverside, O'Connor Woods Retirement Community in Stockton, and among information-technology workers at Kaiser Permanente. The O'Connor Woods unit was later decertified, reversing that organizing gain. From 2012 onward, SEIU-UHW expanded its political activity through California ballot initiatives. The union filed or backed dozens of measures, generally seeking tighter regulation of healthcare companies. Kidney dialysis became the central focus of three successive statewide propositions: Proposition 8 in 2018, Proposition 23 in 2020, and Proposition 29 in 2022. Proposition 8 included a proposed limit on dialysis-clinic profits. Proposition 23 sought, among other requirements, to require a physician to be present during dialysis treatments. Proposition 29 modified that requirement so that a physician, physician assistant, or nurse practitioner could satisfy the presence standard. Critics argued that the measures were bargaining instruments intended to pressure dialysis companies to recognize unions, noting that California dialysis clinics did not have unionized employees represented by SEIU-UHW. SEIU-UHW maintained that the initiatives addressed patient safety and healthcare regulation. The union drew further attention in March and April 2020 during the COVID-19 protective-equipment crisis. It announced access to a proposed supply of 39 million N95 masks and sought to facilitate purchases by healthcare systems and government agencies. The organization later clarified that it had no financial interest in arranging the transactions. Federal investigators discovered that the promised stockpile did not exist, and SEIU-UHW and other intermediaries were among those affected by the scheme. The episode damaged the credibility of the proposed supply effort but was described as a fraud against the intermediaries rather than as a proven financial benefit to the union. In 2020, the local was reported to have approximately 97,000 members, compared with nearly 150,000 in 2013. Its work remains concentrated in California healthcare, with particular emphasis on Southern California organizing, contract enforcement, workplace advocacy, and political campaigns aimed at influencing healthcare employers and regulation.
- 2022
Third successive dialysis proposition
[1]Proposition 29, the third successive dialysis-related measure associated with the union, appeared on the California statewide ballot.
- 2020
Pandemic mask controversy
[1]The union announced a proposed 39-million-mask stockpile, which was later found not to exist.
- 2018
Dialysis Proposition 8 reaches the ballot
[1]SEIU-UHW-backed Proposition 8 proposed limits on dialysis-clinic profits and began a sequence of statewide dialysis initiatives.
- 2010
Kaiser contract ratified
[1]Members at Kaiser Permanente ratified a contract covering about 46,000 California workers and providing 3 percent annual wage increases.
- 2009
Trusteeship and leadership split
[1]SEIU placed the local under trusteeship and removed approximately 70 executives, triggering the formation of the National Union of Healthcare Workers.
- 2004
SEIU-UHW West established
[1]SEIU Local 250 and SEIU Local 399 merged to form SEIU-United Healthcare Workers West, also known as SEIU Local 2005.
- 1974
Support for nonprofit-hospital organizing rights
[1]The predecessor locals helped lobby for a federal legal change that enabled organizing at nonprofit hospitals.
- 1958
Campaign against Proposition 18
[1]The two predecessor locals participated in the BSEIU effort to defeat California's right-to-work Proposition 18.
- 1950
First Kaiser Permanente hospital agreement
[1]Local 399 negotiated an agreement with the first Kaiser Permanente hospital in Los Angeles.
- 1949
Southern California predecessor local formed
[1]Several Southern California local unions consolidated under Charles “Pop” Hardy, creating the organization that became BSEIU Local 399.
Products and positioning
A statewide healthcare-sector labor organization combining collective representation with aggressive organizing and public-policy advocacy in California.
Labor union service
Collective bargaining representation
SEIU-UHW negotiates employment contracts for represented healthcare workers, covering subjects such as wages, benefits, staffing, working conditions, and job protections. Its bargaining units span hospitals, nursing homes, clinics, home-health agencies, and other healthcare settings.
Labor union service
Healthcare worker organizing
The local organizes employees in healthcare and related institutional workplaces, including hospital staff, retirement-community employees, and healthcare information-technology workers. Organizing activity has included campaigns in both Northern and Southern California, with recent emphasis on Southern California.
Labor union service
Member advocacy and workplace representation
The organization provides members with representation in workplace disputes, contract enforcement, grievance processes, and collective actions. It also conducts member education and advocates publicly on issues affecting healthcare workers and patient care.
Public policy advocacy · 2012
Healthcare policy campaigning
SEIU-UHW participates in California legislative and ballot campaigns concerning healthcare companies, clinic regulation, staffing, and patient safety. Its kidney-dialysis initiatives made this political and regulatory work a prominent part of its public profile.
Controversies
2020
Nonexistent N95 mask stockpile
A proposed supply of 39 million N95 masks promoted during the COVID-19 shortage was discovered not to exist. Federal investigators uncovered the scheme while attempting to obtain the shipment for FEMA, and SEIU-UHW said it had no financial interest in the transactions.
2009
Trusteeship and internal union conflict
SEIU's trusteeship of the local and removal of its executives produced a major organizational dispute, followed by the creation of the rival National Union of Healthcare Workers and contested representation elections.
Marketing campaigns
- 2025California Billionaire Tax Act
California
SEIU-UHW filed a proposed initiative that would impose a 5 percent wealth tax on billionaires in California.
- 2022California Proposition 29
California
The third successive dialysis initiative associated with SEIU-UHW adjusted the medical-presence requirement to include a physician, physician assistant, or nurse practitioner.
Outcome. The proposition did not pass.
- 2020California Proposition 23
California
The union-backed measure proposed requiring a physician to be present during dialysis treatments, among other requirements.
Outcome. The proposition did not pass.
- 2018California Proposition 8
California
SEIU-UHW supported a ballot measure concerning dialysis-clinic regulation, including a proposed cap on clinic profits.
Outcome. The proposition did not pass.
- 1958Campaign against Proposition 18
California
The predecessor locals joined the BSEIU campaign opposing a California right-to-work initiative.
Outcome. The measure was defeated.
Brand decisions
2020
Announce protective-equipment supply effortOtherBackground
The COVID-19 pandemic created an acute shortage of protective equipment for healthcare workers.
Action taken
SEIU-UHW announced access to a proposed stockpile of 39 million N95 masks for purchase by hospitals and government agencies.
Aftermath
The stockpile was later found not to exist, and the union stated that it had no financial interest in the proposed transactions.
2010
Ratify Kaiser Permanente contractOtherBackground
Kaiser Permanente workers represented by SEIU-UHW negotiated a new California-wide employment agreement.
Action taken
Members approved a contract covering approximately 46,000 workers and including 3 percent annual wage increases.
Aftermath
The agreement represented one of the local's largest reported bargaining outcomes.
Annual wage increase. 3% (2010 contract)
2009
Place the local under trusteeshipStrategyBackground
SEIU intervened in the governance of UHW West during a dispute involving the local's leadership and the direction of the union.
Action taken
SEIU assumed trusteeship and dismissed approximately 70 local executives, including president Sal Rosselli.
Aftermath
Former leaders formed the National Union of Healthcare Workers, leading to decertification contests at numerous facilities.
2004
Merge Local 250 and Local 399M&ABackground
Two major SEIU healthcare locals represented different regions of California but had a long history of joint political and labor activity.
Action taken
The locals merged to create SEIU-United Healthcare Workers West, also known as SEIU Local 2005.
Aftermath
The merger created a statewide healthcare local with bargaining and organizing operations across California.
Recent events
- 2025
SEIU-UHW files California Billionaire Tax Act initiative[1]
Campaign · Regulation
The union filed a proposed California ballot initiative that would impose a 5 percent wealth tax on billionaires in the state.
- 2022
SEIU-UHW continues dialysis ballot initiative campaigns[1]
Campaign · Regulation
Proposition 29 became the third successive California statewide dialysis-related measure associated with SEIU-UHW, following propositions in 2018 and 2020.
- 2020
SEIU-UHW announces purported stockpile of N95 masks[1]
Other
During the COVID-19 pandemic, the union announced that it had secured access to a potential supply of 39 million N95 masks for hospitals and government agencies, later stating that it had no financial interest in the transactions.
- 2010
Kaiser Permanente workers ratify California contract[1]
Other
SEIU-UHW members at Kaiser Permanente ratified a contract covering approximately 46,000 California workers, including annual wage increases of 3 percent.
- 2009
SEIU places United Healthcare Workers West under trusteeship[1]
Leadership change · Other
SEIU assumed control of the local and removed approximately 70 executives, including president Sal Rosselli. The action led to a major internal dispute and the formation of the rival National Union of Healthcare Workers.
Sources2 sources
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